More lessons learned…

Week III

‘The patients from Mile 4 send greetings and many thanks to our brothers and sisters at University College Galway. May God bless you always.’

‘The patients from Mile 4 send greetings and many thanks to our brothers and sisters at University College Galway. May God bless you always.’

The Medical Missionaries of Mary were founded by a remarkable Irish woman Mother Mary Martin in 1937, dedicated to providing health care in underdeveloped regions of the world.* While working at ‘Mile 4’ hospital (St Patrick’s ), near Abakaliki, eastern Nigeria, Dr Dom Colbert regularly visited the near-by leprosarium, which, despite the pitiful deformities, he describes as a ‘peaceful, tranquil place’. The lepers there were all long-term patients, ‘many had distorted faces, lacked ears or noses…deformities of the hands or feet with missing fingers or toes.’ Recurrent ulceration and infection of the skin required constant attention, dressing changes, and meticulous hygiene.

The patients themselves were always delighted to see someone from the outside world. Dr Dom’s visits became a pleasure for him, rather than a chore. He, and other visitors, could see in the smiling faces, a welcome and happiness. There were children there too, some had been born in the leper colony. In charge was Sr Patricia O’Kane. She was from Belfast, ‘a wiry, bespectacled woman with a kind heart, who truly loved her patients, and tried hard to teach the children some basic lessons’. But they preferred to draw pictures with crayons.

Patricia’s interest in children did not stop with teaching. She managed to pick up a number of orphans who were found often naked and always malnourished, and brought to her. She housed about 12 of them in a makeshift place off the pathway to the leper colony.

When Dom returned to take up his teaching duties at NUIG he asked his medical students to raise funds to employ workmen to improve conditions in the huts, and buy toys for the children. The students responded generously.

Common sense

Often in his book** Dom Colbert is at pains to stress that surgeons are human, they make mistakes. He describes them in some detail, hoping that at least his mistakes would not be a complete waste, but lessons learned by his students. In the case of a young girl, brought to him by her father and mother, he regrets his serious error; not in diagnosis or surgical treatment, but ‘in a lapse of common sense.’

The teenager was suffering from a huge thyroid swelling in her neck. Her parents were deeply concerned that their daughter would never find a husband with such a deformity. It was a straightforward case. If the swelling continued to enlarge, the windpipe would be compressed and the child’s life would be in danger. Nerves could be entrapped, or she might end up unable to swallow. She might even go to a witch doctor who might ‘operate’ with dreadful consequences. Dom agreed to operate. He read up on the procedure the night before, and the next morning, as in all MMM hospitals, the operating team prayed for guidance, and for a good result before making the first incision.

Everything went well. The girl was brought back to the ward, and had regained full consciousness before Dom had finished his usual night round. Next morning to his horror, he discovered that the girl had died. The poor girl had a bout of coughing during the night. She burst her stitches, and bled to death. There was just one night nurse for 48 surgical patients in that ward. It was a mistake to leave his postoperative patient in a busy ward with only one nurse.

Armchair ethics

As a practising Catholic Dom saw a sister doctor tying the tubes of a woman after performing a Caesarean section on her. He was appalled. He knew that the Catholic church expressly forbade sterilisation at that time.

Afterwards the sister took Dom aside. She explained: ‘Dom, this lady already has seven children. This is her second section. Look at that thin uterine scar. She will go home to the bush and get pregnant in a month or so, and she will rupture her uterus when she goes into labour. She will probably die before she reaches hospital, or even after reaching hospital. And then her children will have no mother and will be neglected by their father. I know this place. I cannot take such a high risk. I have to balance medical risk against armchair ethics.’

Dom says he remained quiet, and thoughtful.

Next week: Little miracles in Rwanda

NOTES: *MMM is a Catholic organisation, which today numbers some 400 women from 20 countries, mainly Africa. They follow a Benedictine spirituality, and are trained in a variety of health-related professions. Their special concern is the care of mothers and children, and the fostering of family life. Mother Mary Martin (1892 - 1975 ), was born in Dublin. She found her vocation serving as a nurse in World War I. Three of her brothers died in that war.

**No tears left - Biafra to Bosnia, by Dom Colbert, published by Orpen Press, on sale €15.

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